Person Centred Care

The 4 Pillars of Person Centred Care, and how to apply them in a residential aged care setting, are explained in the great article below from HelloCare.  The 4 pillars are:

  • Uniqueness – Regardless of any medical condition, all people are unique, and this must be acknowledged
  • Complexity – Humans are complex beings and a myriad of factors influence the way we see and respond to the world around us. Always consider the level/type of dementia, personality, life history, physical health status, social life etc.
  • Enabling -It is all too easy for us to focus on the disability and loss associated with cognitive decline and age.We need to recognise the strengths and abilities of all people and ensure opportunities exist for them to be utilised.
  • Value – Person centred care is not just about the way we interact with a person but also recognises the personhood of all people

https://hellocaremail.com.au/4-pillars-person-centred-care/

Opinion piece from a nurse in residential aged care

Why are there more deaths in residential aged care ? Below is a great article from a nurse working in aged care that highlights the need for mandatory staff:resident ratios and adequate government funding. Well worth a read.

https://www.nurseuncut.com.au/an-aged-care-enrolled-nurse-speaks-out/

Earlier this year, a study showed there’d been an increase in preventable deaths in aged care. Kylie’s an aged care nurse and had a sceptical reaction to this study. Aged care is a complex area and there are so any factors at play. Here’s what she thinks.

Kylie: I’m 14 years in aged care … started as a pca and am now an enrolled nurse.

We can continue to point fingers at aged care facilities but until the government puts ratios in place and funds facilities properly, improvements are never going to happen. Recent changes to ACFI mean that getting full funding for a resident that needs it is near impossible.

The study points out three causes for premature deaths – falls, choking and suicide.

Falls: Due to increased services and support for the elderly to remain at home, we are now getting more and more residents that are far more frail and suffering from dementia – we are not allowed to restrain residents (chemically or physically) without very strict protocols and procedures being in place. So how do we stop them from wandering and consequently falling? Increase staffing levels? Nope, the government doesn’t fund enough for that. Restrain them? Illegal and unethical. Remove walking aids so they don’t walk … you’re joking right? They will just walk without them, increasing their risk of falls. So now we demand minimal staff to watch residents with compromised mental state 24/7 like eagles and catch them when they fall … oh, but we are taught not to catch them because it can put both the person trying to catch them and the person falling at risk of injury.

Choking: Again we are now getting residents at the worst of their disease proccess – dementia, CVA, Parkinson’s, etc. Factor in that you then have families who want them to continue to eat and drink a full ward diet because thickened drinks and vitamised meals are bland and unappetising, and the resident agrees… Do we let them starve or do we give them a normal diet? As professionals we explain the risks till we’re blue in the face, we give them the right diet and then you walk in the room and the family has left them a big box of chocolate and the resident is munching away like a kid in a chocolate factory.

Suicide: I must say in 14 years of aged care nursing I have never had to deal with this (I’m certainly not saying it doesn’t happen), but let’s take a look at the government again. The government actually stops funding for professional psychiatric help to any resident not deemed low care, all costs are then on the resident. However, if this resident was at home they would have access to funding through an EPC. So their mental health has to be managed by us nurses who have minimal training in mental health because we are aged care nurses.

All this and we want to blame the aged care facility? Get a grip … nothing is ever as black and white as some would have you believe.

Be clear about what you are looking for in residential aged care

The response to The Age's series on residential aged care, with both positive and negative stories, highlights the need to ask lots of questions and be clear about what you are looking for in aged care. 'Try before you buy' and trial respite care before you make permanent arrangements. There are many places offering great care, as well as some where the standard of care is not adequate.

We hear different reports about care from residents in the same home. Residential care is not 'one size fits all'. Seamless Transitions can work with you to find the aged care that best meets your needs. 
Contact us for more information: info@seamlesstransitions.com.au.

Dementia Township for Victoria

The home away from home
A small, rural public hospital in Victoria is behind a bold proposal to create an entire township for people with dementia.' (The Age, 30/9/17)

https://www.domain.com.au/news/heathcote-health-in-central-victoria-puts-forward-proposal-for-township-for-dementia-patients-20170930-gyqf24/

Staff:Resident Ratios Matter

Another question to ask when you are looking for quality Aged Care is how many Division 1 and Division 2 nurses are rostered on every shift. Then follow this up with a question about staff:resident ratios.  More information is on the link below from the Aged Care Matters Advocacy Group.

https://www.news-mail.com.au/news/cuts-leave-aged-care-staff-with-blues/3210237/

Residents on Interview Panels in Aged Care

Many disability organisations already have client representatives on interview panels. This is worth considering for Aged Care.  The Aged Care Report Card has raised this as an option.

https://www.agedcarereportcard.com.au/hellocare/residents-sit-interviews-hiring-aged-care-staff/

The Aged Care Complaint Commission

An increased number complaints to the Aged Care Complaint Commission about home care can be viewed as positive in one way - at least people are aware of how they can raise issues. 
One thing to watch for when signing up to care at home is exit fees. The agency is entitled to claim for their time, but anything else should be discussed. Remember, the consumer owns the package. 
Contact Seamless Transitions to discuss this furthers.

A great mealtime experience is an important part of quality aged care

Mealtimes are a time for families and friends to get together over good food and just chat. Residential aged care is 'home' for residents, and mealtimes provide opportunities for people to mingle. More and more homes cook everything onsite, including cakes. When looking at residential aged care, take a look at the menu, and ask whether residents are consulted about meals.

Respect Older People

RESPECT OLDER PEOPLE

With all the recent media about the exploitation and mistreatment of older people, Seamless Transitions think it is important to note that this is not true of the whole aged care industry. But while there insufficient government regulation, there will always be some unscrupulous providers.

'Respect for older people' should be the guiding light behind all aged care services.

Senate Review into the Aged Care Workforce

Seamless Transitions welcomes the review into the Aged Care workforce. More information can be found on the link below.  When working with people and their families to find the residential aged care that best meets their needs, the staff at Seamless Transitions ask about staff:resident ratios and the composition of staff. For example, how many Registered Nurses are on duty? 
Seamless Transitions' personalised services take the stress out of this next chapter in a person's life. Contact us: info@seamlesstransitions.com.au

http://www.australianageingagenda.com.au/2017/06/23/senate-report-will-inform-taskforce-on-aged-care-workforce-wyatt/?platform=hootsuite

Retirement Villages open to exploitation. The industry needs to be regulated.

There has been a lot of stories in the medial recently about the financial dealings of Aveo in relation to their many retirement villages.  We cannot stress enough the importance of consulting a lawyer before signing any contracts, particularly the long complicated ones that are often used in retirement villages.  Below are links to the 4 Corners/Fairfax investigation into Aveo.  

Seamless Transitions strongly supports government regulation of the aged care industry.  Older people can be particularly vulnerable to exploitation.

http://www.theage.com.au/interactive/2017/retirement-racket/the-price-of-freedom/

http://www.theage.com.au/interactive/2017/retirement-racket/the-get-poor-quick-scheme/

http://www.theage.com.au/interactive/2017/retirement-racket/bleed-them-dry/

http://www.theage.com.au/comment/the-age-editorial/the-retirement-racket-official-probe-needed-into-retirement-village-industry-20170626-gwyy2e.html?btis

Training for aged care workers not consistent

Quality aged care hinges on adequate training for staff. Outstanding training would be even better.

According to The Aged Care Report Card:

A survey found that one in eight aged care employers said that training graduates had “insufficient experience, inadequate communication or teamwork skills’’. The problem seems to lie in the short courses that are being offered. Some workers are getting their Certificate III in a mere 6 weeks.

See the full article on the link below

https://www.agedcarereportcard.com.au/hellocare/aged-care-homes-hiring-staff-lacking-basic-skills-2/

Residential Aged Care: more choice and control

We recently worked with an elderly gentleman who reluctantly moved into residential aged care after fracturing his hip. His plan was to move back to his isolated home when he regained his strength. Twelve months later he is still happily residing in residential aged care. He has lots of friends and joins in activities that appeal to him. He says that if he was at home he would be lonely, and his days would be spent struggling to keep up with maintaining his home, and would have little time for just having fun.

Sometimes the thought of moving into residential aged care is based on fear of losing independence. In reality, there is often more opportunities to make the choices that enable people to live the life they choose. 

More Choice and Control for Consumers receiving Home Care Packages

Recent change to Home Care packages, where older people are supported to remain in their own homes, give consumers more choice and control over the services they receive. They can use different service providers to have services delivered when and how they want. 
Seamless Transitions can take the stress out of accessing different services, helping you choose the providers that best meet your needs. 

http://www.theage.com.au/money/planning/more-choice-for-elderly-to-receive-aged-care-at-home-20170310-guv45v

Involving older people in their personal aged care

Aged care is not a 'one size fits all'. The importance of engaging older people is essential to offering quality care, as explained in the article below. 
At Seamless Transitions we ask what is important to you and work with you to find the aged care that best meets your needs.

http://www.australianageingagenda.com.au/2017/03/17/engaging-older-people-key-to-better-aged-care/#.WMwCgzxqYcc.facebook

3 Important nutrition tips to consider in aged care

While it has long been recognised that children have different nutritional needs from adults due to the fact that they are growing and developing both mentally and physically, these days there is now also a growing understanding of the fact that older adults likewise have different nutritional needs from their younger counterparts. Those who care for the elderly have a duty to ensure that they are provided with appropriate food and that they are able to eat it comfortably.

Malnutrition and obesity in older adults

As we get older we may find ourselves with less appetite than in our younger days and/or we may find it becomes physically more difficult to eat, either in general or with regards to certain, specific types of food. The most obvious example of this is when people have false teeth, but people with conditions such as rheumatism and arthritis may also find it difficult to hold cutlery with enough grip to cut food into bite-sized pieces. At the same time, we often become less active and our metabolisms may slow. This means that while we still require nourishment, our calorie intake needs to be reduced to reflect the change in our lifestyles. We may also need to look at the practicalities of how we eat food, for example switching to softer foods, which need less cutting, biting and chewing and using sporks rather than the standard fork, knife and spoon.

Calcium-rich foods are crucial

Older people need plenty of calcium for the same reason that children do - to maintain the health of bones and teeth. As we age, our bones naturally become more brittle and our teeth often fall out. Calcium can help to counteract this. While the most obvious source of calcium is dairy products, there are actually plenty of alternative sources for those who can't or don't want to eat dairy, for example green, leafy vegetables and some fruit juices both contain calcium as does a lot of canned fish where the bones are left in, e.g. sardines. Even when an individual is happy to eat dairy foods, some caution is still required as these can be very high in fat and hence contribute to obesity in a person who leads a sedentary lifestyle and some dairy foods, such as blue and/or soft cheeses, also have specific health hazards. They may be low-risk to adults in their prime, but high risk to older people.

Vitamin D is vital

Vitamin D is needed to regulate the amount of calcium and phosphate in our bodies. Hence vitamin D deficiency can lead to serious problems with bones and teeth, such as rickets or osteomalacia. The main source of vitamin D is sunlight, but as we age, our ability to create vitamin D from sunlight decreases and also, we may spend less time out in the sun. Red meat is a good alternative source of vitamin D, but, of course, can trigger other health issues. Therefore for many older people, the best sources of vitamin D are: oily fish, liver, egg yolks and products fortified with vitamin D. There is also the option of using a specific, vitamin D supplements, although it is recommended to speak to a doctor before going down this route.

We are grateful to Gillian Douglas, Medical Writer for Oxley Home Care( http://oxleyhomecare.com.au/) for providing this article.

Techonology must not reduce human contact

Technology to monitor the health and safety of older people is worth pursuing, as long as it doesn't reduce contact with real people. Social isolation and depression are also real problems that must not be overlooked.  More information about technology to monitor seniors is on the link fro Aged Care Report below:

https://www.agedcarereportcard.com.au/blog/Senior-Safety-Robotic-Roommate